Savva Christos, Korakakis Vasileios, Efstathiou Michalis, Karagiannis Christos
Department of Health Science, European University, Diogenous 6, Engomi, Nicosia, Cyprus.
Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
J Bodyw Mov Ther. 2021 Apr;26:279-289. doi: 10.1016/j.jbmt.2020.08.019. Epub 2020 Sep 2.
Although both neural mobilization (NM) and cervical traction (CT) are widely used interventions in cervical radiculopathy (CR), there is limited clinical data to support their use.
To evaluate the effects of CT, with or without the addition of NM, on pain, function, and disability in patients with CR.
A randomized, double-blinded, placebo-controlled clinical trial.
66 patients with CR were randomly allocated to: a group (n = 22) received CT combined with NM (CT + NM), a group (n = 22) received CT combined with sham NM (CT + shamNM) and a wait-list control (WLC) group (n = 22). The Neck Disability Index (NDI), the Patient-Specific Functional Scale, the Numeric Pain Rating Scale (NPRS), grip strength and cervical spine mobility were used as outcome measures. A two-way analysis of variance was used to evaluate differences between the three groups at baseline and at 4-week follow-up.
Statistically and clinically significant between-group differences at 4-week follow-up were found between CT + NM and WLC groups in favor of CT + NM group in NDI scores (d = 1.30), NRPS (d = 1.94), and active cervical rotation towards the opposite arm (d = 1.18) and between CT + NM and CT + shamNM groups in favor of CT + NM group in NRPS (d = 1.21). No significant differences were observed between CT + shamNM and WLC groups in all outcome measures. Clinically significant within-group improvements were found only for the CT + NM group.
At 4-week follow-up, CT in combination with NM resulted in improved outcomes in pain, function and disability in patients with CR.
尽管神经松动术(NM)和颈椎牵引(CT)都是广泛用于治疗神经根型颈椎病(CR)的干预措施,但支持其使用的临床数据有限。
评估CT单独或联合NM对CR患者疼痛、功能和残疾状况的影响。
一项随机、双盲、安慰剂对照临床试验。
66例CR患者被随机分为三组:一组(n = 22)接受CT联合NM(CT + NM),一组(n = 22)接受CT联合假NM(CT + 假NM),以及一个等待名单对照组(WLC)(n = 22)。采用颈部残疾指数(NDI)、患者特定功能量表、数字疼痛评分量表(NPRS)、握力和颈椎活动度作为结局指标。采用双向方差分析评估三组在基线和4周随访时的差异。
在4周随访时,CT + NM组与WLC组之间在NDI评分(d = 1.30)、NRPS(d = 1.94)以及向对侧手臂的主动颈椎旋转(d = 1.18)方面存在统计学和临床意义上的组间差异,支持CT + NM组;CT + NM组与CT + 假NM组之间在NRPS(d = 1.21)方面存在统计学和临床意义上的组间差异,支持CT + NM组。CT + 假NM组与WLC组在所有结局指标上均未观察到显著差异。仅CT + NM组在组内有临床意义的改善。
在4周随访时,CT联合NM可改善CR患者的疼痛、功能和残疾状况。